Risk factors differ for Gram-negative surgical site infection following hip and knee arthroplasty: an observational study from a national surveillance system

被引:0
作者
Chhibber, Aakash, V [1 ]
Roberts, Sally A. [1 ,2 ]
Grae, Nikki [3 ]
Morris, Arthur J. [1 ,4 ]
机构
[1] Auckland City Hosp, Dept Microbiol, Auckland Dist Hlth Board, Auckland, New Zealand
[2] Hlth Qual & Safety Commiss, Infect Prevent & Control Programme, Wellington, New Zealand
[3] Hlth Qual & Safety Commiss, Qual Syst Grp, Wellington, New Zealand
[4] Hlth Qual & Safety Commiss, New Zealand Surg Site Infect Improvement Programm, Wellington, New Zealand
关键词
IMPROVEMENT PROGRAM; SOCIOECONOMIC-FACTORS; UNITED-STATES; JOINT; IMPACT; OUTCOMES; RATES;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
AIM: To describe risk factors for surgical site infection (SSI) caused by aerobic Gram-negative organisms after hip and knee arthroplasty. METHOD: Publicly funded hip and knee arthroplasties (performed between 1 July 2013 and 31 December 2017) that developed SSIs were compared to those that did not. SSIs were grouped by causative organism: Gram-negative (Pseudomonas spp. or enteric Gram-negative bacilli) or staphylococcal (pure or mixed growth of Staphylococcus spp.). Independent risk factors in each group were identified. RESULTS: 24,842 (54%) hip and 20,993 (46%) knee arthroplasties were performed. There were 497 (1.1%) SSIs. Staphylococci were responsible for 233 SSIs (47%) and Gram-negatives were responsible for 73 (15%). Age, sex, body mass index >= 35kg/m(2), smoking status, socioeconomic deprivation, American Society of Anesthesiologists classification, revision surgery and prophylactic antibiotic dose were all independent predictors of all-cause SSI. On subgroup analysis, socioeconomic deprivation and Pasifika ethnicity were independent risk factors for Gram-negative SSI, but not staphylococcal SSI. DISCUSSION: In this study, socioeconomic deprivation and ethnicity were independent and novel risk factors for Gram-negative SSI following arthroplasty. Some of the SSI risk factors can be modified before arthroplasty (e.g., appropriate timing of prophylactic antibiotics, smoking cessation, weight loss). Non-modifiable risk factors can help identify high-risk procedures where additional pre- and post-operative interventions may be warranted.
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页码:47 / 61
页数:15
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共 37 条
  • [1] Gram-negative prosthetic joint infection treated with debridement, prosthesis retention and antibiotic regimens including a fluoroquinolone
    Aboltins, C. A.
    Dowsey, M. M.
    Buising, K. L.
    Peel, T. N.
    Daffy, J. R.
    Choong, P. F. M.
    Stanley, P. A.
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2011, 17 (06) : 862 - 867
  • [2] Alamanda VK, 2019, BONE JOINT J, V101B, P3, DOI [10.1302/0301-620X.101B1.BJJ-2018-0233.R1, 10.1302/0301-620x.101b1.bjj-2018-0233.r1]
  • [3] Atkinson June., 2014, NZDep2013 Index of Deprivation
  • [4] Impact of Socioeconomic Factors on Outcome of Total Knee Arthroplasty
    Barrack, Robert L.
    Ruh, Erin L.
    Chen, Jiajing
    Lombardi, Adolph V., Jr.
    Berend, Keith R.
    Parvizi, Javad
    Della Valle, Craig J.
    Hamilton, William G.
    Nunley, Ryan M.
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2014, 472 (01) : 86 - 97
  • [5] Prevalence and risk factors for colonisation with Gram-negative bacteria in an intensive care unit
    Blot, S
    Vandewoude, K
    Blot, K
    Colardyn, F
    [J]. ACTA CLINICA BELGICA, 2000, 55 (05): : 249 - 256
  • [6] A perioperative care map improves outcomes in patients with morbid obesity undergoing major surgery
    Boodaie, Benjamin D.
    Bui, Anthony H.
    Feldman, David L.
    Brodman, Michael
    Shamamian, Peter
    Kaleya, Ronald
    Rosenblatt, Meg
    Somerville, Donna
    Kischak, Patricia
    Leitman, I. Michael
    [J]. SURGERY, 2018, 163 (02) : 450 - 456
  • [7] The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization
    Bozic, KJ
    Ries, MD
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2005, 87A (08) : 1746 - 1751
  • [8] The Frank Stinchfield Award The Impact of Socioeconomic Factors on Outcome After THA A Prospective, Randomized Study
    Butler, R. Allen
    Rosenzweig, Seth
    Myers, Leann
    Barrack, Robert L.
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2011, 469 (02) : 339 - 347
  • [9] Burden of Six Healthcare-Associated Infections on European Population Health: Estimating Incidence-Based Disability-Adjusted Life Years through a Population Prevalence-Based Modelling Study
    Cassini, Alessandro
    Plachouras, Diamantis
    Eckmanns, Tim
    Abu Sin, Muna
    Blank, Hans-Peter
    Ducomble, Tanja
    Haller, Sebastian
    Harder, Thomas
    Klingeberg, Anja
    Sixtensson, Madlen
    Velasco, Edward
    Weiss, Bettina
    Kramarz, Piotr
    Monnet, Dominique L.
    Kretzschmar, Mirjam E.
    Suetens, Carl
    [J]. PLOS MEDICINE, 2016, 13 (10)
  • [10] Centres for Disease Control and Prevention, 2015, PROC ASS EV